Killing two gaps with a single activation map—Visualization of the precise macroreentrant circuit including the pulmonary vein and left atrium Hiro Yamasaki,

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Date of download: 5/28/2016 Copyright © The American College of Cardiology. All rights reserved. From: Left atrial tachycardia after circumferential pulmonary.

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Presentation transcript:

Killing two gaps with a single activation map—Visualization of the precise macroreentrant circuit including the pulmonary vein and left atrium Hiro Yamasaki, MD, Tomoaki Hasegawa, MD, Kazutaka Aonuma, MD, Akihiko Nogami, MD HeartRhythm Case Reports Volume 4, Issue 10, Pages 494-496 (October 2018) DOI: 10.1016/j.hrcr.2018.07.001 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 A: Activation mapping of an atrial tachycardia demonstrated a centrifugal activation pattern with the earliest left atrial (LA) activation at the posterior carina of the right pulmonary vein (PV). At the earliest activation site, the LA and PV signals were fused. The window of interest (WOI) of the acquired activation map was adjusted to annotate the LA potentials. B: The automatically readjusted activation map after readjusting the WOI only to annotate the PV potential inside the antrum clearly demonstrated the entry site of the antrum at the anterior carina. LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; PA = posterior-anterior; RIPV = right inferior pulmonary vein; RL inf = right lateral inferior; RSPV = right superior pulmonary vein. HeartRhythm Case Reports 2018 4, 494-496DOI: (10.1016/j.hrcr.2018.07.001) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 A: Local signal of the posterior carina during sinus rhythm, where the earliest atrial activation was recorded during the atrial tachycardia. Of note, the left atrial (black arrow) and pulmonary vein (black arrowhead) signals at the posterior carina were fused during sinus rhythm (first complex) and also during the extrasystoles from the right superior pulmonary vein (second complex). B: Fluoroscopic view of the successful isolation site at the posterior carina. ABL = ablation; AP = anterior-posterior; CS = coronary sinus; LAO = left anterior oblique. HeartRhythm Case Reports 2018 4, 494-496DOI: (10.1016/j.hrcr.2018.07.001) Copyright © 2018 Heart Rhythm Society Terms and Conditions